The nurse is counseling a female patient who has unsuccessfully attempted to become pregnant through a variety of methods and treatments for infertility. Which psychosocial manifestation is the nurse most likely to recognize?

Correct Answer: C

Rationale: The correct answer is C: Difficulty accepting pregnancy if it does occur. A patient who has struggled with infertility may have developed emotional barriers or fears related to pregnancy due to past disappointments. This psychosocial manifestation is common in individuals who have faced challenges with fertility. It is important for the nurse to recognize and address this potential issue during counseling. A: Close connections with extended family is not the most likely psychosocial manifestation in this scenario. While extended family support can be beneficial, it may not be the primary concern for a patient struggling with infertility. B: Strong intimate relationship with her partner is important for coping with infertility, but it is not the most likely manifestation for the nurse to recognize in this scenario. D: Greater focus on career and job opportunities is not the most likely psychosocial manifestation for a patient struggling with infertility. While some individuals may prioritize their career, the primary concern in this case is related to emotional challenges with pregnancy acceptance.

Correct Answer: B

Rationale: The correct answer is B: to assess the risk of chromosomal abnormalities in the fetus. Maternal assays and multiple marker screenings in the first trimester are used to evaluate the risk of conditions like Down syndrome. These tests measure levels of certain proteins and hormones in the mother's blood to assess the likelihood of chromosomal abnormalities in the fetus. Options A, C, and D are incorrect because determining the gender of the fetus, monitoring placental growth, and detecting maternal infections are not the primary purposes of these screenings in the first trimester.

Correct Answer: D

Rationale: The correct answer is D: thyroid function tests. During pregnancy, thyroid function is crucial for the health of the mother and baby. Thyroid disorders can lead to complications. Testing thyroid function in the first trimester helps detect any abnormalities early. A, B, and C are commonly performed tests in pregnancy, but they are not specific to the first trimester. A CBC helps assess overall health, blood type and Rh factor are important for identifying potential blood type incompatibilities, and urinalysis can indicate urinary tract infections or other issues. However, these tests are not unique to the first trimester and are typically done throughout pregnancy.

Correct Answer: B

Rationale: Percutaneous umbilical blood sampling is recommended to detect Down syndrome accurately by analyzing fetal blood. This is because it directly tests the fetal blood for chromosomal abnormalities like Down syndrome, providing a definitive diagnosis. Other choices are incorrect because A does not specify the need for a direct blood test, C is too general, and D can be determined using other non-invasive methods like amniocentesis.

Correct Answer: C

Rationale: The correct answer is C because relaxin plays a role in the appearance of the linea nigra during pregnancy. Linea nigra is a dark line that runs from the belly button to the pubic bone caused by hormonal changes. Choices A, B, and D are incorrect. Relaxin primarily affects the cervix and pelvic ligaments, making them softer and more flexible to prepare for childbirth, but it does not help decrease peripheral vascular resistance or directly aid in skin stretching.